Category: Statistics

Cureus. 2024 Oct 17;16(10):e71714. doi: 10.7759/cureus.71714. eCollection 2024 Oct.

ABSTRACT

Introduction Oral lichen planus (OLP) comprises a chronic inflammatory autoimmune disease observed in the oral cavity. It most commonly manifests as white papules arranged confluently, drawing a picture of white lines in the form of a network (reticular form). It may emerge in other forms as well. In our study, the erosive form presents the most clinical interest. Among the biomarkers that participate in the tumorigenesis process, DAPK-1 seems promising, rendering its study necessary. This study focuses on the investigation of the presence of the DAPK-1 using immunohistochemistry in OLP compared to oral squamous cell carcinoma (OSCC), oral leukoplakia (OL), a well-established oral potentially malignant disorder, and normal oral epithelium to evaluate its possible role as an early predictor of the possibility of malignant transformation risk of OLP lesions. Methods To monitor the expression profile of the tumor suppressor protein DAPK-1, an immunohistochemical detection took place in 18 samples of OLP (reticular and erosive type), in 22 OSCC samples of all degrees of differentiation, in 30 OL samples of all degrees of dysplasia, and five normal tissue samples used as the control group. To complete the above procedure, immunohistochemistry was used in a semiquantative manner. The paraffin-embedded tissue samples were selected from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, from biopsies performed in this department as well as from St. Lukas Hospital of Thessaloniki, Greece, between 2014 and 2019. The study was conducted per the Research and Ethics Committee guidelines of Aristotle University, School of Dentistry, and the Helsinki II declaration (protocol number 29/21.11.2018). Results The statistical analysis showed that there was no statistically significant difference in DAPK-1 staining between normal tissues and OLP (p=0.588, independent-samples Kruskal-Wallis test). On the other hand, there was a statistically significant difference between OSCCs and OLPs (p<0,001, independent-samples Kruskal-Wallis test), with the extent of expression of DAPK-1 being greater in OLP than in OSCC. In addition, there was a statistical difference in DAPK-1 expression between OLPs and OLs (p=0,001, independent-samples Kruskal-Wallis test), with DAPK-1 being expressed more in OLP than in OL. Conclusion The DAPK-1, as a pro-inflammatory with its role as a tumor suppressor factor, was highly expressed in OLP, both reticular and erosive. The relatively milder expression of DAPK-1 in OL means that, between the two disorders, OLP is less likely to progress to oral cancer. On the other hand, OLP could also offer the background for further investigation of a possible correlation between methylation (immunohistochemical expression of proteins, deriving from potentially DNA-methylated genes) and the development of inflammation. It appears that DNA methylation is important in the regulation of inflammatory genes. Conversely, inflammation may regulate the DNA methylation of many genes involved in carcinogenesis and thus should be taken into account when studying the methylation behavior of genes such as DAPK-1 in pathologies characterized by a sparse inflammatory infiltrate.

PMID:39553125 | PMC:PMC11568832 | DOI:10.7759/cureus.71714

Cureus. 2024 Oct 29;16(10):e72667. doi: 10.7759/cureus.72667. eCollection 2024 Oct.

ABSTRACT

BACKGROUND: Understanding the attributes of vertical patterns is essential for delivering optimal orthodontic care. Cone-beam computed tomography (CBCT) represents a valuable resource for assessing the buccolingual inclination of the teeth. The present research delves into examining the buccolingual inclination of premolars in nongrowing individuals exhibiting diverse vertical facial patterns.

METHODS: CBCT scans of 66 adult patients (31 males and 35 females), mean age 31.6 years (SD = 6.4 years), exhibiting class II division I maxillomandibular relationships, were employed. Participants were categorized into three groups based on linear and angular measurements: normodivergent group (n = 22), hypodivergent group (n = 22), and hyperdivergent group (n = 22). The independent samples t-test and Mann-Whitney U test were conducted to investigate statistical differences in the buccolingual inclination of the premolars among the three vertical patterns.

RESULTS: Statistically significant differences between the three groups were observed in the buccolingual inclinations of both maxillary and mandibular first and second premolars (p < 0.05). The upper right first premolars exhibited a significantly increased buccal inclination in the normodivergent group compared to the hypodivergent group (p < 0.05). In contrast, the two groups had no notable differences in the inclination of the remaining premolars. The upper right and left first premolars exhibited a significantly increased buccal inclination in the hyperdivergent group compared to the hypodivergent group (p < 0.05). In contrast, there were no notable differences in the inclination of the remaining premolars between the two groups. The lower left first premolars exhibited a significantly increased lingual inclination in the hyperdivergent group compared to the normodivergent group (p < 0.05). In contrast, the two groups had no notable differences in the inclination of the remaining premolars. The upper right second premolars exhibited a significantly increased buccal inclination, and the lower left second premolars exhibited greater lingual inclination in the normodivergent group than in the hypodivergent group (p < 0.05). In contrast, there were no notable differences in the inclination of the remaining premolars between the two groups. The upper right and left second premolars exhibited a significantly increased buccal inclination, and the lower left second premolars exhibited greater lingual inclination in the hyperdivergent group than in the hypodivergent group (p < 0.05). In contrast, there were no notable differences in the inclination of the lower right second premolars between the two groups. There were no notable differences in the inclination of the second premolars between the hyperdivergent and normodivergent groups.

CONCLUSIONS: In individuals presenting with class II relationships, the buccolingual inclinations of the first and second premolars exhibit similarities and variations across distinct facial patterns. As such, it is imperative for orthodontic practitioners to exercise meticulous consideration of these nuances throughout treatment.

PMID:39553121 | PMC:PMC11568827 | DOI:10.7759/cureus.72667

Cureus. 2024 Oct 17;16(10):e71724. doi: 10.7759/cureus.71724. eCollection 2024 Oct.

ABSTRACT

Background As populations age, musculoskeletal disorders significantly affect the quality of life (QOL) and functional independence of elderly individuals. While BMI is commonly used to assess nutritional status and is linked to physical function, the relationship between BMI reduction and improvements in activities of daily living (ADL) remains unclear in elderly patients with musculoskeletal disorders. This study aimed to explore this relationship in a rehabilitation setting. Methods This retrospective cohort study included 75 elderly patients (65 years and older) with musculoskeletal disorders admitted to a convalescent rehabilitation ward. Patients were categorized into two groups based on BMI reduction: those with a decrease of ≥0.7 kg/m² and those with <0.7 kg/m². Functional Independence Measure (FIM) scores were recorded at admission and discharge. Statistical analyses, including logistic regression, were conducted to examine the relationship between BMI reduction and FIM improvement. Results There was no significant difference in FIM gain between the BMI-reduced and non-BMI-reduced groups. Logistic regression analysis also found no significant association between BMI reduction and FIM improvement, even after adjusting for age, gender, length of stay, and initial FIM scores. Discussion The absence of a significant association may be due to factors such as postoperative swelling, comorbidities, and the predominance of female participants, who may experience less muscle mass loss. Study limitations include the lack of data on dietary intake and body composition. Future research should include broader assessments, such as muscle mass and swelling, to better evaluate rehabilitation outcomes in elderly patients with musculoskeletal disorders.

PMID:39553114 | PMC:PMC11568862 | DOI:10.7759/cureus.71724

Pak J Biol Sci. 2024 Oct;27(11):526-536. doi: 10.3923/pjbs.2024.526.536.

ABSTRACT

&lt;b&gt;Background and Objective:&lt;/b&gt; Polycystic Ovarian Syndrome (PCOS) is a hormonal abnormality that influences the age during reproduction. This investigation aimed to identify the impact of insulin receptor-encoding genes (NsiI and PmLI) on the development of PCOS and their effect on insulin and HOMA-IR levels. &lt;b&gt;Materials and Methods:&lt;/b&gt; The study included 80 patients and 25 healthy individuals. The concentrations of HOMA-IR, fasting blood sugar and fasting insulin hormone were determined. The PCR-RFLP was applied to identify insulin receptors in the NsiI and PmLI SNPs. Sanger sequencing was used for each of these patients. The study data were analyzed using SPSS version 16.0 and using χ&lt;sup&gt;2&lt;/sup&gt; test p<0.05 was considered statistically significant. Also, Hardy-Weinberg equilibrium for genotype frequencies was used. &lt;b&gt;Results:&lt;/b&gt; The HOMA-IR and mean insulin levels significantly differed between the control subjects and PCOS females (“p = 0.002 and “p = 0.000, correspondingly). Concerning the odds ratio and their NsiI frequency polymorphisms in the heterozygote genotype A/G and homozygote mutant G/G groups were greater in PCOS than control individual (OR = 1.14, p>0.05) (OR = 5.20, p>0.05). However, for the PmLI polymorphism, CC and TT were linked with pathogenic effects for PCOS susceptibility (OR = 1.83, p>0.05) (OR = 12.07, p>0.05) and CT was a protective factor (OR = 0.22, p<0.05). &lt;b&gt;Conclusion:&lt;/b&gt; A strong relationship between high levels of hormone insulin as well as elevated HOMA-IR has been found in women with PCOS. Furthermore, INSR gene polymorphisms may be a molecular marker associated with decreased insulin sensitivity in women with PCOS.

PMID:39551955 | DOI:10.3923/pjbs.2024.526.536

Age Ageing. 2024 Nov 1;53(11):afae239. doi: 10.1093/ageing/afae239.

ABSTRACT

OBJECTIVES: The relationship between nut intake and disability-free survival (healthy lifespan) in later life is unclear. The objective was to evaluate the association between nut intake and disability-free survival in a cohort of adults aged ≥70 years, and whether this varied according to overall diet quality.

METHODS: This prospective cohort study involved 9916 participants from the ASPREE Longitudinal Study of Older Persons. Participants completed a 49-item Food Frequency questionnaire from which frequency of nut intake was obtained and were asked to categories usual intake as no/infrequent [never/rarely, 1-2 times/month], weekly [1-2 times/week, often 3-6 times/week] or daily [every day or several times a day]. The outcome measured was a composite of first-event mortality, onset of dementia, or persistent physical disability. Cox proportional hazards regression models, adjusted for socio-demographic factors, health-related and clinical covariates and overall dietary quality were conducted to examine the association between varying levels of nut intake and disability-free survival.

RESULTS: Over a mean of 3.9 years of follow-up, the risk of reaching the DFS endpoint were 23% lower (HR 0.77 [0.61-0.98]) for those who consumed nuts daily, when compared to those with no/infrequent nut consumption. Subgroup analysis demonstrated a significant association between daily nut consumption and healthy lifespan among individuals in the second dietary quality tertile (HR 0.71[0.51-0.98]).

CONCLUSION: For community-dwelling adults aged 70 years and over with sub-optimal diets, daily nut consumption is associated with the promotion of healthy lifespan (disability-free survival).

PMID:39551942 | DOI:10.1093/ageing/afae239

Brain Behav. 2024 Nov;14(11):e70133. doi: 10.1002/brb3.70133.

ABSTRACT

INTRODUCTION: A smartphone is a device with various functions, including wifi, application functions, mobile networks, ease of mobility, and the capability of using mobile data. Because of the aforementioned functions, people may use smartphones frequently. The Smartphone Application-Based Addiction Scale (SABAS) is a six-item questionnaire assessing smartphone addiction with promising psychometric properties. However, it is unclear if the SABAS possesses the strong psychometric properties across Asian regions. The present study aimed to examine the factor structure of the SABAS across nine Asian regions.

METHODS: Using datasets collected from Asian regions of Bangladesh, China, Indonesia, Iran, Malaysia, Pakistan, Taiwan, Thailand, and Vietnam, data from 10,397 participants (mean age = 22.40 years; 44.8% men) were used for analyses. All participants completed the SABAS using an online survey or paper-and-pencil mode.

RESULTS: Findings from confirmatory factor analysis, Rasch analysis, and network analysis all indicate a one-factor structure for the SABAS. Moreover, the one-factor structure of the SABAS was measurement invariant across age (21 years or less vs. above 21 years) and gender (men vs. women) in metric, scalar, and strict invariance. The one-factor structure was invariant across regions in metric but not scalar or strict invariance.

CONCLUSION: The present study findings showed that the SABAS possesses a one-factor structure across nine Asian regions; however, noninvariant findings in scalar and strict levels indicate that people in the nine Asian regions may interpret the importance of each SABAS item differently. Age group and gender group comparisons are comparable because of the invariance evidence for the SABAS found in the present study. However, cautions should be made when comparing SABAS scores across Asian regions.

PMID:39551939 | DOI:10.1002/brb3.70133

Healthc Inform Res. 2024 Oct;30(4):333-343. doi: 10.4258/hir.2024.30.4.333. Epub 2024 Oct 31.

ABSTRACT

OBJECTIVES: This study aimed to assess the feasibility of implementing OpenNotes in Korea. It involved developing and evaluating the Open-CHA service, which provides clinical summary information to patients diagnosed with craniofacial deformities and their caregivers following outpatient visits.

METHODS: The study included 109 patients diagnosed with craniofacial deformities, along with their caregivers. The Open-CHA service was developed by referencing OpenNotes and involved a user needs assessment, a pilot test, and an evaluation of its effectiveness. Data were analyzed using descriptive statistics and the paired t-test.

RESULTS: Short message service templates for the Open-CHA service based on a user needs assessment conducted with patients, caregivers, and healthcare professionals. These templates were refined and improved following a pilot test. After the implementation of the Open-CHA service, most participants evaluated OpenNotes positively. Additionally, there were observed increases in health knowledge and efficacy in patient-physician interactions. A statistically significant improvement in mobile health literacy was also confirmed.

CONCLUSIONS: The implementation of the Open-CHA service significantly enhanced mobile health literacy among patients with craniofacial deformities and their caregivers, indicating positive outcomes for the potential adoption of OpenNotes in Korea. This suggests that introducing OpenNotes into the Korean healthcare system is appropriate.

PMID:39551920 | DOI:10.4258/hir.2024.30.4.333

Healthc Inform Res. 2024 Oct;30(4):312-323. doi: 10.4258/hir.2024.30.4.312. Epub 2024 Oct 31.

ABSTRACT

OBJECTIVES: The spread of misinformation through the internet can lead to dangerous behavioral changes and erode trust in reliable sources, especially during public health crises like coronavirus disease 2019 (COVID-19). To combat this issue, innovative strategies that leverage information technology are essential. This study focused on developing and evaluating a mobile application (app), COVID-Iran, aimed at countering COVID-19 misinformation by delivering accurate, reliable, and credible information.

METHODS: The development of the app involved a multi-step, user-centered approach that integrated qualitative expert consultations with quantitative survey research to pinpoint and validate key features. The app was initially prototyped using Enterprise Architect software and subsequently developed using Android Studio and MySQL. We conducted a usability evaluation using the System Usability Scale (SUS), where participants engaged in various tasks related to information seeking, self-assessment, and health management. Data were analyzed using descriptive statistics in SPSS version 19.

RESULTS: The findings revealed a high usability level (SUS score of 81.35), with participants reporting ease of use and learnability. The app effectively countered misinformation by providing access to trusted sources and evidence-based counterarguments. User feedback emphasized the app’s strengths in clarity, accuracy, trustworthiness, and its comprehensive approach. Plans for future improvements include the integration of artificial intelligence to deliver personalized content.

CONCLUSIONS: Despite limitations such as the small sample size and potential self-selection bias, this study highlights the significant potential of mHealth apps to provide reliable health information and combat misinformation.

PMID:39551918 | DOI:10.4258/hir.2024.30.4.312

Support Care Cancer. 2024 Nov 18;32(12):798. doi: 10.1007/s00520-024-08986-2.

ABSTRACT

PURPOSE: The impact of the components of survivorship care plans on adherence to cancer screening guidelines among cancer survivors is limited. We examined the association of receipt of treatment summaries, follow-up instructions, and type of doctor providing survivorship care with adherence to breast cancer screening (BCS) and cervical cancer screening (CCS) guidelines in female cancer survivors.

METHODS: A cross-sectional analysis using Behavioral Risk Factor Surveillance System (BRFSS) data from 2014, 2016 and 2018 was conducted. BCS and CCS-eligible women were aged 40-74 and 30-64, respectively. BCS adherence was defined as a mammogram within 2 years and CCS adherence as a pap smear within 3 years or HPV test within 5 years. Univariate analysis with chi-square and multivariable logistic regression are reported.

RESULTS: 5,001 BCS and 3,014 CCS-eligible survivors were identified. In the BCS group, recipients of treatment summaries and follow-up instructions were significantly more adherent with BCS (84.1% vs. 77.4%; 83.4% vs. 74%, respectively, p < 0.001). In the CCS group, recipients of follow-up instructions were significantly more adherent with CCS (78.1% vs. 67.7%, p < 0.001). In both groups, there was no significant difference in BCS or CCS based on type of physician providing care (p = 0.087). On multivariate analysis, receipt of follow-up instructions was the only factor significantly associated with BCS (OR:2.81; 95%CI:1.76-4.49) and CCS (OR:3.14; 95%CI:1.88-5.23).

CONCLUSIONS: Follow-up instructions, as part of survivorship care plans, have the strongest association with BCS and CCS among female cancer survivors. Additional research should focus on improving the distribution of survivorship care plans, particularly follow-up instructions, as a method to increase BCS and CCS among cancer survivors.

PMID:39551914 | DOI:10.1007/s00520-024-08986-2

Eur Arch Psychiatry Clin Neurosci. 2024 Nov 18. doi: 10.1007/s00406-024-01935-4. Online ahead of print.

ABSTRACT

The modulation of gut microbiota through probiotics holds promise as a novel avenue for schizophrenia treatment. This study aims to analyze probiotic complementary therapy on individuals with schizophrenia systematically, to investigate probiotic efficacy, potential mechanisms, and implications for clinical practice. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched in Medline, Web of Science, Embase, ClinicalTrials.gov, CNKI, VIP, and WanFang databases using keywords (“probiotics” OR “prebiotics” OR “synbiotics” OR “Lactobacillus” OR “Bifidobacterium”) AND (“schizophrenia”), focused on randomized controlled trials published before July 1, 2023. Among the identified studies, 8 randomized controlled trials met the inclusion criteria, encompassing a total of 342 participants in the intervention group and 306 participants in the control group. Our analysis revealed a statistically significant reduction (p = 0.03) in the total Positive and Negative Syndrome Scale (PANSS) scores following probiotic treatment in individuals with schizophrenia. While no statistical significance was observed in individual subscales (P > 0.05), significant improvements were noted in insulin levels, Insulin Resistance Index (IRI), and glucose levels. Additionally, the Quantitative Insulin Sensitivity Check Index (QUICKI) demonstrated a significant increase (all P < 0.05). The probiotic intervention significantly reduced gastrointestinal discomfort among schizophrenia patients (P = 0.003). This study suggests that probiotics could hold therapeutic potential for addressing clinical symptoms, abnormal glucose metabolism, and gastrointestinal discomfort in individuals with schizophrenia. Future research should encompass comparative trials employing robust experimental designs to explore the differential effects of various probiotic strains on schizophrenia treatment to provide evidence-based therapeutic approaches. TRIAL REGISTRATION: This review protocol was pre-registered on PROSPERO (No. CRD42023455273).

PMID:39551901 | DOI:10.1007/s00406-024-01935-4